| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,147 |
2,710 |
$217K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,226 |
3,670 |
$203K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
125 |
120 |
$11K |
| 90688 |
|
374 |
297 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
75 |
66 |
$6K |
| 87428 |
|
59 |
59 |
$4K |
| 0012A |
|
84 |
63 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
240 |
208 |
$3K |
| 0064A |
|
64 |
64 |
$3K |
| 0011A |
|
98 |
67 |
$2K |
| 90686 |
|
247 |
206 |
$2K |
| 90658 |
|
84 |
37 |
$2K |
| 99402 |
|
40 |
36 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90619 |
|
47 |
32 |
$848.58 |
| 0031A |
|
17 |
17 |
$675.13 |
| 0072A |
|
13 |
13 |
$547.82 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
15 |
$251.20 |
| 90656 |
|
14 |
14 |
$233.94 |
| 90651 |
|
14 |
14 |
$89.60 |
| 90734 |
|
13 |
13 |
$83.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
48 |
$0.00 |